Return of the Bedside Nurse

Well, I have "become" a bedside nurse once again in my career and just past my one year anniversary of my new job. I am so blessed by my coworkers and patients. I keep telling the "baby" nurses on our unit that if they can work here, they can work anywhere. This is the busiest nursing unit I have ever worked on! Maybe I'm too old for 12 hour shifts?? Nah...I just need more ibuprofen and espresso.

hablo un poquito espanol y no comprendo mucho

I have finished orientation at my new job and am now orienting on my home unit. I had the pleasure of taking care of a patient who's primary language is spanish. Poor thing, I got to drag out my spanish and practice it on her. Actually, she understood me and we communicated!! Hot damn, I guess all that spanish I took in school paid off :D.

Anywho... it has been a great week and I am so happy to be back at the bedside with the patients and their families. Like a blog I read today, I feel like a 'fish in the water.' But, now, I've got 4 days off; so, I'm off to screw around.

Happy weekend!!
Su enfermera, AzRN

Long time, no blog....

Well, this picture kinda sums up what I've been doing the past couple of months... watching the horizon to see what is next. I've been through a lot in the last 6 months and am now on the cusp of a new adventure. I decided that being the "big boss" is ok, but not what I signed up for when I went to nursing school. So, I've gone back to the bedside and am having a blast!

For now, I'm working per diem as an "agency" nurse, but am in second round interviews for a clinical leadership position at a local hospital. Wish me luck as I really feel it would be a great position where I would be able to use my leadership skills, but still get to work in patient care.

In the meantime, I've been using my days off to clean around the house and get rid of the clutter. I haven't felt this free in a long time. Wow! I love picking the days and times I'll work. It is great to be able to have so much control over my time and schedule. I've been able to spend more time participating in our church youth group activities. I've been having so much fun.

The best thing that happened this past week? There were several (in no particular order): the Giants winning the Super Bowl..great game, my patient's girlfriend who got teary-eyed and gave me a hug when I told her I was being sent home early..."RG, you came every time we needed you, today," and the cardiac surgeon who smiled and introduced himself after I informed him who I was at his patient's bedside (hi, I'm RG. I'm Mr. x's RN today).

Geez...I'm a goober....Happy Monday!

busy, busy

It's been a while since my last post as life seems to be overtaking my time to blog. Memorial day brought family to town for a visit. We all ended up at mom's house to eat and spend time together. We also visited the local waterpark and had a blast riding all the slides we could find. Later on my brother astounded us with feats of strength!

In July went on the high school missions trip with our youth group from church. This year the group headed to Jamaica. We built a house for a pastor there and ran vacation bible school (VBS) for a week. In the rural community where we went to build the parsonage, pastors rotate through or visit sporadically while staying with local congregation members as there is no where for these pastors to stay. So we decided to go and build a two room house in order to plant a pastor in a church! We went with members of our 'sister' church in all there were 36 of us.

I was part of the VBS group and got to organize the games for VBS. The theme was 'SCUBA' which was an acronym for Super Cool Underwater Bible Adventures. So my games centered around the Bible verses and concepts we were teaching and I tried to name them something to do with animals found in the ocean or Bible characters. The pic below is of the Jonah boat races where is each child has a bowl, a cotton ball (Jonah), and a straw. They put Jonah in boat and use the straw to be the wind and race their boats against one another without blowing Jonah overboard.

The kids loved it as they were quite a distance from the ocean up in the hills. I think they loved playing in the water more than anything. Me too!

Oh, yeah, I found a new job, too. I started right before I left for Jamaica. I've been at the new hospital for two months and, get this, I'm the boss!!

whatcha doin?

Have you ever felt like putting on your wrestling suit at work? Well, this past year has been very difficult at the hospital where I work. Reading TrenchDoc's blog
made me think about how it seems that none of the administration ever values the experienced staff. Anyway, I definitely have felt the call of the luchadore. I think I'd be the one on the left, but add a flowing turquoise cape to my ensemble.

So, after a year of experiencing my new manager's feeble attempts at managing staff much more experienced than her, I am searching for a new job. I have updated my CV and resume, bought a new suit from Brooks Bros, and warned my immediate family members that I may need to relocate in order to find the right spot for me. I hate doing this, but after bringing forward issues as a group, my colleagues and I were told that "there weren't any real issues presented." Now, I'm not one to rock the boat, but as many of us were targeted and treated unfairly, we banded together to go to HR. To be treated like this has made many of us leave and others to look for new positions. Of course, manager and her boss are spinning this to their advantage; all the while, morale sinks to a new low and turn over rises to a new high - 50%.

If not a luchadore, how about manager of the local Starbuck's? Stock options, beautiful green apron (which may double as cape), and a free pound of coffee a week for those suffering from caffeine addiction. Sounds pretty good to me! If you screw up, everyone gets a free coffee. Much better outcomes than some of my patients. I wonder if Starbuck's experiences as much turn over as our department has in the last year?

How about ER nursing? I could ditch the ole suit and wear my awesome collection of scrubs to work! I'd be able to use my background in triage with my keen wit to learn a new and exciting specialty. When my kiddo goes to college in 3 (count 'em with me) years, I could take my act on the road and see the world. And, I would be able to wear my favorite scrub dress of all time. You know, the one all the old folks think are flowers, but are really flying pigs :D
Hmmmm...that might be fun for a while.

Acute Liver Success

Got a page late in the day from the PI, "The fellow admitted an ALF patient yesterday (Sunday)." That's code for some poor patient is in the ICU with acute liver failure and I want you to go sign them up for our study. Honestly, I enjoy being the research nurse/coordinator, but it doesn't mean it gets any easier to go and sign up potential participants. This poor guy in particular....

"Hey, AZ! Whatcha doin' up here in the unit," asked MH, the charge nurse? "I came to screen the ALF patient. Do you know who's taking care of him, right now?" "Sure do, he's in 7 with Linda. Let me give ya her number...."* "Hi, Linda, it's AZ. Is there any family in the room with ya? Great, I'll be in after I check the chart."

I start flipping pages looking for the EMT report. The paramedics and EMTs have the best record of what happened at the scene as well as documenting the time when this all started. This is really important as I have 24 hours from incident in which to enroll participants. I start looking for the things that will disqualify the patient from my study. So far, so good. I grab a chair and pull myself up to the computer to check his current lab results. Okie doakie, looks like we're good. I grab my consent form, take a deep breath, and walk into room 7 to see the family.

It always amazes me how different people look when they're in the unit lying in bed intubated. This poor guy must have taken a tumble from the bruising on his face and arms. His wife is sitting quietly watching him from across the room as I enter. She is slightly older than me and reminds me of my neighbors. I introduce myself to her and tell her who I am. I explain that we are participating in an international study trying to figure out more about ALF. She gives me permission to discuss the consent form with her and I do...page by page. I explain everything and answer her questions. "Can I keep this and think about it a little more," she asks me. "Of course, you can. I need to let you know that we have to enroll everyone within 24 hours of coming to the hospital and we only have 4 hours left. I'll come back in a little while."

I finish reading the dictated history and find Linda to fill in the blanks for me. "Well, let's see...around 0200 he came into the bedroom and his wife told him to go downstairs as she was trying to sleep," Linda said. "Around 0600, she heard a 'thump' in the bathroom and found him down on the ground. It looked like he had vomitted up a plastic bag with some crystals in it," Linda shook her head as she said this. "We think it's meth, but we're not sure," Linda finished. I was at a loss for words. That guy looked like the guy down the street who mows his lawn with strategic precision. I couldn't believe my ears...meth?! I mean all my other ALF patients (so far) looked a lot more worldly than Mr. 7. I was floored. This man was the father of two small children 10 and 7. How do you explain this to them?

I went back to get the consent form and see if Mrs. 7 wanted to enroll her husband. She said, "I sure do." She handed me the consent form and everywhere it read 'acute liver failure' she had crossed out failure and written in the word 'success.' I asked her about the changes, and she responded, "I believe we need to be positive that what the doctors are doing here will be a success." "Well," I started, "this is a legal document and we can't sign one where it's been changed like this." "I'm sorry," she said, "I won't sign one that says 'acute liver failure.' I just feel like that's giving up on my husband." I thanked her and headed for my office. I called the PI and let him know what happened. You know, folks have to cope the best way they can.

I do know that the intensivists and nurses did their magic and brought this guy back from the edge of the drain. Last I heard, the patient had been discharged to a skilled nursing facility of some sort. I don't know what happened to him after that, but I do know I'll never forget him. I hope he has more than just acute liver success.


*Our hospital is extremely communication friendly; so, the staff nurses all wear portable phones as do most the inpatient staff. The others, like myself, wear pagers; so, we're obtainable at all times (during working hours).

Didja screen 'em, yet??

I just hate this question, my being a research coordinator and all. If you think you found a patient for a study, then, you must be part of the study team. As said member of the team, I have not only put together consenting packets, but have also posted study inclusion/exclusion as well as the most current version of the consent form on the transplant server (you remember the computer??) in the nicely organized study folder. Why don't you screen and consent them? You just saw the potential participant. Not to mention the fact that you just paged me away from the bedside of a patient I'm consenting in pre-op....Hello??